Congenital Heart Disease
Day 7-14: Lesions dependent on pulmonary or systemic blood flow through the ductus arteriosus (e.g., hypoplastic left heart syndrome, critical coarctation of the aorta) present with shock and acidosis as the duct begins to close.
>Day 14: Lesions that involve left-to-right shunting of blood (ASD/VSD) typically present after the second week of life as pulmonary vascular resistance falls, allowing pulmonary overcirculation and the onset of congestive heart failure.
Most of these anomalies are identified prior to discharge.
Upper respiratory tract problems: choanal atresia, laryngomalacia, tracheomalacia, micrognathia, macroglossia, tracheoesophageal fistula, vascular slings
Lower respiratory tract: congenital lobar emphysema, sequestration, cystic adenomatous malformation, congenital diaphragmatic hernia
All these diagnoses should be considered in any infant with respiratory distress. Admission and work up is needed for diagnosis.
Inborn Errors of Metabolism (IEM)
|Image taken from http://what-when-how.com/acp-medicine/the-adrenal-part-2/|
Intracranial and Intra-abdominal Hemorrhage
Neonates with abdominal distention, dehydration, bilious vomiting may have underlying congenital malrotation leading to midgut volvulus and bowel infarction. Necrotizing enterocolitis is classically seen in premature infants with poor feeding; abdominal distension, tenderness, and discoloration; lethargy or irritability; vomiting or diarrhea; temperature instability; apnea; and circulatory collapse. Other possibilities include testicular torsion and NAI.
Tintinalli textbook of EM - 8th edition